{"id":940,"date":"2019-04-22T12:55:49","date_gmt":"2019-04-22T12:55:49","guid":{"rendered":"http:\/\/www.jpeterstclairdentistry.com\/blog\/?p=940"},"modified":"2019-04-22T12:55:49","modified_gmt":"2019-04-22T12:55:49","slug":"breathing-is-important-part-1","status":"publish","type":"post","link":"https:\/\/www.jpeterstclairdentistry.com\/blog\/breathing-is-important-part-1\/","title":{"rendered":"BREATHING IS IMPORTANT \u2013 PART 1"},"content":{"rendered":"\n<ul class=\"wp-block-gallery columns-1 is-cropped wp-block-gallery-1 is-layout-flex wp-block-gallery-is-layout-flex\"><li class=\"blocks-gallery-item\"><figure><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"768\" src=\"https:\/\/www.jpeterstclairdentistry.com\/blog\/wp-content\/uploads\/2019\/04\/46196007381_325bf0d466_k-1024x768.jpg\" alt=\"\" data-id=\"945\" data-link=\"https:\/\/www.jpeterstclairdentistry.com\/blog\/?attachment_id=945\" class=\"wp-image-945\" srcset=\"https:\/\/www.jpeterstclairdentistry.com\/blog\/wp-content\/uploads\/2019\/04\/46196007381_325bf0d466_k-1024x768.jpg 1024w, https:\/\/www.jpeterstclairdentistry.com\/blog\/wp-content\/uploads\/2019\/04\/46196007381_325bf0d466_k-300x225.jpg 300w, https:\/\/www.jpeterstclairdentistry.com\/blog\/wp-content\/uploads\/2019\/04\/46196007381_325bf0d466_k-768x576.jpg 768w, https:\/\/www.jpeterstclairdentistry.com\/blog\/wp-content\/uploads\/2019\/04\/46196007381_325bf0d466_k.jpg 2048w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/figure><\/li><\/ul>\n\n\n\n<p>About seven\nyears ago I took a weekend course at Tufts University School of Dental Medicine\nentitled &#8220;Sleep Dentistry&#8221;. This was not a course in putting patients\nto sleep for their dental work. This particular course was an introduction to\ntreating people who had been diagnosed with sleep apnea (a sleep breathing\ndisorder) by a medical doctor, and could not (or would not even consider) the use\nof the dreaded CPAP machine.<\/p>\n\n\n\n<p>CPAP, which stands\nfor Continuous Positive Airway Pressure, is a facial mask which blows air\nthrough the nose to create an &#8220;air stent&#8221; to basically hold the\nairway open during sleep. Patients with sleep apnea have been diagnosed with a\nprogressive disease in which breathing is decreased at least 90% for more than\n10 seconds multiple times an hour. Most people know someone who has been\ndiagnosed with this disease and either uses a CPAP machine, or cannot use it. <\/p>\n\n\n\n<p>The\n&#8220;sleep dentistry&#8221; part of the equation is that for those who have\nbeen diagnosed with sleep apnea and cannot use the CPAP machine, the next line\nof defense is a dental device. This is worn at night to hold the lower jaw slightly\nforward and not allow the jaw to fall back during sleep. Holding the lower jaw\n(mandible) forward helps to prevent the tongue from falling back in the mouth\nduring sleep and obstructing the airway.<\/p>\n\n\n\n<p>I was excited\nabout this course I had taken at Tufts, and thought that I was going to start\ntreating all these people I heard about who were not able to tolerate or didn\u2019t\nwant to use CPAP. The problem I found was that sleep apnea needed a medical\ndiagnosis, which meant that patients had to have already had a sleep study with\na physician, have failure in the use of CPAP, and then somehow find their way\nto my office. I was frustrated. I wasn&#8217;t treating that many patients, but knew\n(or at least thought), I must need more education. <\/p>\n\n\n\n<p>So, I enrolled\nin a mini-residency program at Tufts for 8 months. This was a much more\nintensive program with heavy emphasis on the science behind the disease, which\nincluded more reading of scientific papers than I had ever done. The program\nwas great and I felt I had now &#8220;figured it out&#8221;. That was 2 years\nago.<\/p>\n\n\n\n<p>I was much\nmore knowledgeable about things to look for in patients, and was referring many\npatients to physicians to be evaluated. Some patients would end up having a\nsleep study, be diagnosed with sleep apnea, go on CPAP, and then come back to\nmy office and say, literally, &#8220;you changed my life.&#8221; There is no greater\nfeeling than that. Even though I didn&#8217;t get to treat them with my fancy dental\nappliance, they were being treated for a disease that was slowly (or not so\nslowly) killing them. <\/p>\n\n\n\n<p>There were\nalso those patients who had the sleep study, were diagnosed with sleep apnea,\nwere not able to (or didn\u2019t want to) use CPAP and were referred back to me for\ndental appliance therapy. Great!!! However, I quickly became frustrated again.\nFar too many patients, with classic symptoms such as snoring and daytime\nfatigue, were returning to me, saying they had a sleep study that showed they\ndid not have apnea. Now what?<\/p>\n\n\n\n<p>&nbsp;I&#8217;m a dentist, not a physician. Sleep problems\nare medical problems. And, although I knew that many of these patients may have\nsleep issues that were out of my control as a dentist (there are over 100 sleep\ndisorders), many of these patients had dental signs such as wear on their\nteeth, grinding and\/or clenching problems, TMJ pain, and other anatomic issues\nthat I had learned about that were likely related to breathing problems. So,\nwhat did I do? I decided I needed more education. <\/p>\n\n\n\n<p>\u2026\u2026.continued\nnext week<\/p>\n\n\n\n<p>Dr. St. Clair\nmaintains a private dental practice in Rowley and Newburyport dedicated to\nhealth-centered family dentistry. If there are certain topics you would like to\nsee written about or questions you have please email them to him at <a href=\"mailto:jpstclair@stclairdmd.com\">jpstclair@stclairdmd.com<\/a>.\nYou can view all previously written columns at <a href=\"https:\/\/www.jpeterstclairdentistry.com\/blog\">www.jpeterstclairdentistry.com\/blog<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>About seven years ago I took a weekend course at Tufts University School of Dental Medicine entitled &#8220;Sleep Dentistry&#8221;. This was not a course in putting patients to sleep for their dental work. This particular course was an introduction to treating people who had been diagnosed with sleep apnea (a sleep breathing disorder) by a medical doctor, and could not (or would not even consider) the use of the dreaded CPAP machine. CPAP, which stands [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-940","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/www.jpeterstclairdentistry.com\/blog\/wp-json\/wp\/v2\/posts\/940","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.jpeterstclairdentistry.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.jpeterstclairdentistry.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.jpeterstclairdentistry.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.jpeterstclairdentistry.com\/blog\/wp-json\/wp\/v2\/comments?post=940"}],"version-history":[{"count":2,"href":"https:\/\/www.jpeterstclairdentistry.com\/blog\/wp-json\/wp\/v2\/posts\/940\/revisions"}],"predecessor-version":[{"id":946,"href":"https:\/\/www.jpeterstclairdentistry.com\/blog\/wp-json\/wp\/v2\/posts\/940\/revisions\/946"}],"wp:attachment":[{"href":"https:\/\/www.jpeterstclairdentistry.com\/blog\/wp-json\/wp\/v2\/media?parent=940"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.jpeterstclairdentistry.com\/blog\/wp-json\/wp\/v2\/categories?post=940"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.jpeterstclairdentistry.com\/blog\/wp-json\/wp\/v2\/tags?post=940"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}